Reversible Cerebral Vasoconstriction Syndrome with Intracranial Hypertension: Should Decompressive Craniectomy Be Considered?

Background: Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of intracerebral hemorrhage (ICH) causing intracranial hypertension.

Methods: Case report.

Results: We report a case of RCVS-related ICH leading to refractory intracranial hypertension.

Postoperative complications after craniotomy for brain tumor surgery.

Introduction: After elective craniotomy for brain tumour surgery, patients are usually admitted to an intensive care unit (ICU) for monitoring. Our goal was to evaluate the incidence and timing of neurologic and non-neurologic postoperative complications after brain tumour surgery, to determine factors associated with neurologic events and to evaluate the timing and causes of ICU readmission.

Patients And Methods: This prospective, observational and analytic study enrolled 188 patients admitted to the ICU after brain tumour surgery.

The optimal time between clinical brain death diagnosis and confirmation using CT angiography: a retrospective study.

Background: In several countries, a computed tomography angiography (CTA) is used to confirm brain death (BD). A six‑hour interval is recommended between clinical diagnosis and CTA acquisition despite the lack of strong evidence to support this interval. The aim of this study was to determine the optimal timing for CTA in the confirmation of BD.

Optimal perioperative management of arterial blood pressure.

Perioperative blood pressure management is a key factor of patient care for anesthetists, as perioperative hemodynamic instability is associated with cardiovascular complications. Hypertension is an independent predictive factor of cardiac adverse events in noncardiac surgery. Intraoperative hypotension is one of the most encountered factors associated with death related to anesthesia.

Accidental dural puncture: combination of prophylactic methods to avoid post-dural puncture headache.

Accidental dural puncture (ADP) is a common complication of epidural catheter insertion, and may lead to post-dural puncture headache (PDPH), especially in obstetric patients. Epidural blood patch (BP) is the most effective treatment of PDPH. Prophylactic BP has shown its efficacy to prevent PDPH; nevertheless, this method may be insufficient.

Anesthetic regimen for cardiac function evaluation by echocardiography in mice: comparison between ketamine, etomidate and isoflurane versus conscious state.

Mice with genetic alterations are used in heart research for the extrapolation of human diseases. Echocardiography is an essential tool for evaluating cardiac and hemodynamic functions in small animals. The purpose of this study was to compare the effect of different anesthetic regimens and the conscious state on the evaluation of cardiac function by echocardiography.

Apnea test for brain death determination in a patient on extracorporeal membrane oxygenation.

Background: Apnea test is a key component to confirm brain death. For patients receiving extracorporeal membrane oxygenation (ECMO), apnea test remains challenging. Brain death (BD) diagnosis is often made without apnea test.

[Video laryngoscopic tracheal intubation under sedation].

We report a video laryngoscopic tracheal intubation under sedation in a patient with a hip fracture. Preoperative assessment revealed signs of difficult airway management linked to a cervical spine immobilization. Here we describe an alternative method to awake fiber optic flexible intubation.

[Pulmonary embolism and pregnancy].

Objective: Pulmonary embolism remains a leading cause of maternal death in France and in other developed countries. Prevention is well codified, but management remains complex both for diagnosis and therapeutics. The objective of this review was to update the knowledge on diagnosis and treatment of pulmonary embolism during pregnancy.

Continuous spinal anaesthesia for a total hip arthroplasty in a patient with an atrial septal defect.

Atrial septal defect (ASD) is often diagnosed and repaired during childhood. Nevertheless, it is the most common congenital cardiac defect seen in adults. ASD is characterized by a left-to-right intracardiac shunt and pulmonary hypertension.

[Continuous spinal anesthesia and pulmonary arterial hypertension].

We report the use of continuous spinal anesthesia for hip fracture surgery in a patient with pulmonary arterial hypertension. Preoperative evaluation, anesthetic technique and preoperative monitoring are discussed.

Brainstem hemorrhage following decompressive craniectomy.

Decompressive craniectomy (DC) is used for the management of refractory raised intracranial pressure, but the impact of DC on surgical outcome is still controversial. We report a 21-year-old man admitted to our hospital after a road traffic accident. The brain CT scan revealed a left hemispheric acute subdural hematoma.

Early encephalic toxicity after inadvertent intrathecal injection of low osmolar contrast medium.

Only nonionic contrast media are allowed for intrathecal use because of their lower neurotoxicity. In case of inadvertent intrathecal administration of an ionic contrast medium, the typical following syndrome is called ascending tonic clonic seizure syndrome. We describe the case of a 61-year-old woman with low back pain who underwent myelography.

Relative accuracy of arterial and capillary glucose meter measurements in critically ill patients.

Aim: As optimizing glucose control in critically ill patients remains a challenge for intensive-care physicians, this study aimed to determine the accuracy of glucose measurements.

Methods: The accuracy of capillary and arterial blood glucose meter measurements was compared with central laboratory arterial glucose measurements; the factors associated with inaccurate measures were also determined.

Results: Altogether, 302 samples from 75 patients were assessed.